Have you ever stood at the checking bench, staring at a prescription, close to tears, paralysed by anxiety at the thought of handing it out, not able to let it go, convinced something is wrong, not believing your eyes, worried people will be hurt or worse because you missed something?
Have you ever repeatedly taken bagged prescriptions from the storage shelf to recheck over and over and driven to a patient’s home after work to recheck some items? I have.
What is OCD
The charity OCD-UK explains: “Obsessive-Compulsive Disorder (OCD) is a serious anxiety-related condition that affects 1.2% of the population, which is around three-quarters of a million people here in the UK based on current estimates.
Obsessive-Compulsive Disorder (or more routinely referred to as OCD) is a serious anxiety-related condition where a person experiences frequent intrusive and unwelcome obsessional thoughts, commonly referred to as obsessions.
Obsessions are very distressing and result in a person carrying out repetitive behaviours or rituals in order to prevent a perceived harm and/or worry that preceding obsessions have focused their attention on. Such behaviours include avoidance of people, places or objects and constant reassurance-seeking. Sometimes the rituals will be internal mental counting, checking of body parts, or blinking, all of these are compulsions.
Compulsions do bring some relief to the distress caused by the obsessions, but that relief is temporary and reoccurs each time a person’s obsessive thought/fear is triggered.”
My obsessive thoughts were about incorrectly checking prescriptions and causing harm to people as a result. Consequently, my compulsion was to check, check, check, check…
It impacted me at home as well. I would be halfway to work in the morning before being convinced I hadn’t locked the front door and turning the car round to check.
There was no particular incident that triggered the OCD, but I believe the origins for me were rooted in the checking nature of pharmacy, the stress, the responsibility and the potential consequences of an error. Checking is a fundamental part of pharmacy, and this lends itself so well to OCD.
In the book ‘The Man Who Couldn’t Stop: The Truth About OCD,’ David Adam describes: “It is not the accuracy of recall that matters in OCD, but a loss of confidence that those memories are true. People who carry out compulsive checks seem to trust their memory less, and the more they check, the more this distrust grows. It is another vicious cycle: memory uncertainty provokes the need to check, and to check increases memory uncertainty. It is altered perception, and there is some evidence that, just as to check damages confidence in memory, so to stare, even for a few seconds, reduces confidence in the information collected by the eyes.”
Diagnosis
I was diagnosed with OCD in the early 2000s when colleagues realised I wasn’t well after observing my anxiety with checking prescriptions. I knew something was wrong, the anxiety of over-checking was exhausting, but I didn’t know what was wrong and what to do about it. A couple of trusted colleagues came to see me about their concerns, and I broke down. From there I went on sick leave, had counselling, went to my GP, and have worked with a psychologist and psychiatrist over the years. Having a diagnosis helps in knowing what you’re dealing with and then in learning how to manage it.
Ultimately, I needed to step away from the dispensary, and a non-patient-facing role was identified that would work for me. For the last several years I’ve found the ideal role for me, which allows my anxiety, stress and OCD symptoms to be minimised so that I am in control rather than the OCD. My wife and family noticed the difference in me when I began the role, as though a weight had been lifted from my shoulders.
Receiving help
These days, third-party helplines are provided by companies for colleagues to talk through difficulties. However, I believe companies should be more proactive in protecting the mental health of their employees. This would see specific training to management to help identify colleagues who are struggling and then how to approach them.
For example, the Trades Union Congress (TUC) recommends that training around mental health awareness is provided for all staff, and that line managers in particular ought to receive more specific training around how to support staff with mental health problems and how to handle difficult conversations.
In my case, a change to a less stressful working environment made a huge difference. Other adjustments employers can make to support employees with OCD include:
- Adopting a flexible approach when setting deadlines for tasks
- Providing time off work to access therapy
- Offering a buddy system, whereby there is a trusted colleague to discuss anxieties with
- Providing disability leave
- Offering a managed return to work.
I believe that raising awareness of OCD in pharmacy is essential to reduce the suffering of colleagues, which will thereby improve the service we provide to the public.
If anything I’ve written has struck a chord with you, then please ask for help. I found David Adam’s book ‘The Man Who Couldn’t Stop: The Truth About OCD’ really helpful as it offered me both support and explanations. OCD-UK is a national charity and support organisation that can help. I have also recently joined the PDA’s Ability Network.
Related links
Get involved
If you would like to share your story of working as a pharmacist with a disability, please contact PDA Regional Official, Richard Hutton on: ability@the-pda.org. We would like to be able to share examples of good employment practice and member stories and issues. You must be a pharmacist and can remain anonymous.
Equally, if you would like to share positive examples of working with and supporting patients with disabilities, that would be helpful so that members can learn from your experience.
Join the PDA Ability Network
The Ability Network provides a structure through which members can work together to proactively address and campaign around disability discrimination and its causes and consequences. Membership is open to pharmacists with disabilities and those pharmacists who are allies and want to support the network.
Contact the Ability Network on: ability@the-pda.org
All contact with the network will be treated in confidence and with sensitivity.
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